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Creating families as a same-sex couple

Professor Geeta Nargund

IVF is enabling thousands in the LGBT+ community to create families, but understanding about a more natural and safer treatment options can be an important first step.

As a fertility doctor, helping same-sex
couples create families is something I take great pride in. Fertility treatments
provide a unique platform to create much-needed equality and diversity in
society, and ever since the first IVF baby was born just over 40 years ago,
thousands of LGBT couples now have the chance to start a family.

This Pride, it’s important to celebrate the
options that are now available to same-sex couples, with more receiving
fertility treatments than ever before. In 2017, over 4,000 fertility treatment
cycles were undertaken by patients in female same-sex relationships, a 12%
increase from 2016.

What does the process involve?

For lesbian couples who are looking to start
a family, it’s important to speak to a fertility doctor in the first instance.
They will be able to test your fertility potential and egg reserve, ensuring
that you receive the treatment best suited to your needs. You can discuss any
questions about donor sperm with your doctor.

Initially, couples may try Intra-Uterine
Insemination (IUI), where donor sperm is injected directly into the womb around
the time of ovulation. However, becoming a parent is a journey that both
partners may want to be physically and emotionally involved in. One option
couples may consider is Reciprocal IVF, sometimes called partner IVF, which enables
lesbian couples to use one partner’s eggs while the other carries the baby.

IVF has allowed countless same-sex couples to fulfil their dream of becoming parents.

What is IUI?

IUI involves donor sperm being directly
inserted into the uterus when a woman is at the most fertile point of her
natural cycle. This method is the most popular first-line treatment for
same-sex couples, as it is less invasive, more natural and less expensive, and
suits those who have no problems with their fallopian tubes and have a good egg
reserve.

Natural IUI is done in a woman’s natural ovulatory
cycle, without the use of stimulation drugs, and relies on the natural
selection of egg/s, rather than the eggs resulting from stimulation of ovaries.
This method can be safer, more successful and less costly than stimulated cycle.

However, when partners wish to physically
share the journey of becoming a parent, they may choose IVF instead. As most
same-sex couples may not have existing fertility problems, IVF treatments involving
lengthy courses of stimulation drugs may not be necessary. A gentler approach
to IVF can be beneficial, using lower amounts of drugs over a shorter period of
time, to give couples the success and safety they deserve.

What is Natural IVF?

In Natural IVF, egg/s naturally selected by
the ovaries are collected and fertilised with donor sperm. The resulting embryo
is then implanted into the womb.

Natural IVF treatment does not require
stimulation hormones and is therefore useful for women who cannot take or
choose to avoid stimulation drugs.

It is also beneficial for women with a low
egg reserve, where stimulation hormones have no added benefits in achieving
success.

What is Mild IVF?

Mild Stimulation IVF uses lower doses
of hormone injections for around 5-10 days during a woman’s natural cycle,
aimed at achieving a higher quality rather than quantity of eggs, and results
in a “mild response” from the ovaries. Once the eggs have been collected and
fertilised, the resulting embryo is inserted into the womb, and any surplus
embryos can be frozen for future use.

Mild IVF reduces the burden of
treatments on women, such as ovarian hyperstimulation syndrome, whilst achieving
success rates equivalent to conventional high-dose IVF. It is suitable for
women with normal egg reserve and those with polycystic ovarian syndrome.

Helping you understand all your options

Not all IVF clinics offer these lower
drug options, but it’s important for lesbian couples to be aware that they can
opt for less drug intensive IVF treatments, especially if they have no existing
fertility issues. Carefully researching the safer and successful options can protect
you from potential side effects, health risks and financial costs. It’s
important to make an informed decision before you embark on IVF treatment.

IVF has allowed countless same-sex couples to fulfil their dream of becoming parents and has the potential to not only improve equality and diversity in the fertility space, but also in our society – I am proud to be a part of this movement.